摘要
目的探究能谱CT单能量成像联合去金属伪影(Metal Artifacts Reduction,MAR)技术在心脏起搏器植入术后的临床应用。方法选取2021年2—5月于我院行能谱CT检查的44例心脏起搏器植入患者,将原始数据作为非MAR组,MAR重建作为MAR组,扫描后处理得到混合能量及70~140 keV单能量的图像。在金属伪影覆盖面积最大的层面,高、低密度伪影区的胸大肌、胸小肌及对侧的背侧脂肪组织划取感兴趣区(Region of Interest,ROI),测量CT值、标准差,计算伪影指数(Artifact Index,AI)及对比噪声比(Contrast to Noise Ratio,CNR),采用配对样本t检验及单因素方差统计分析。两名医师按照图像伪影、组织对比及综合评分对图像进行主观评分,并采用Kappa值检验评分一致性。结果随着keV增长,AI值及CNR值均逐渐降低;相同keV时,MAR组的AI值、CNR值均显著低于非MAR组(P<0.05)。两名医师评分一致性较好(Kappa值为0.873),110 keV综合评分最高。结论能谱CT高keV单能量成像联合MAR技术可以去除心脏起搏器植入术后CT扫描过程中产生的金属伪影,并且100~120 keV是观察周围软组织的最佳单能量范围。
Objective To investigate the clinical application of metal artifacts reduction(MAR) combined with spectrum CT monoenergetic imaging after cardiac pacemaker implantation. Methods A total of 44 patients with cardiac pacemaker implantation who underwent energy spectrum CT examination in our hospital from February to May 2021 were selected. The original data were used as the non-MAR group, and MAR reconstruction was used as MAR group. Images of the two groups with mixed energy and 70-140 keV single energy were obtained by post-processing. At the level with the largest coverage area of metal artifacts, the pectoralis major, pectoralis minor and the dorsal adipose tissue on the contralateral side in the areas of high and low density artifacts were divided into region of interest(ROI), and the CT value and standard deviation value were measured. Artifact index(AI) and contrast to noise ratio(CNR) were calculated and analyzed by paired sample t test and one-way variance statistical. Two physicians scored the images subjectively according to the image artifact,tissue contrast and comprehensive scores, and the consistency was evaluated by Kappa test. Results The AI value and CNR value in the shadow area gradually decrease with the increase of ke V. At the same ke V, the AI value and CNR value of MAR group was significantly lower than that of non-MAR group(P<0.05). The two physicians had a good consistency(Kappa value of 0.873), and the 110 ke V composite score was the highest. Conclusion High ke V spectrum CT monoenergetic imaging combined with MAR technique can effectively be used to remove metal artifacts after cardiac pacemaker implantation during CT scanning and 100~120 ke V is the best single energy range for observing soft tissue around pacemaker.
作者
施康
储晨
杨尚文
王铭君
李茗
胡安宁
辛小燕
SHI Kang;CHU Chen;YANG Shangwen;WANG Mingjun;LI Ming;HU Anning;XIN Xiaoyan(Department of Radiology,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing Jiangsu 210008,China;GE(China)CT Imaging Research Center,Shanghai 200210,China)
出处
《中国医疗设备》
2022年第8期104-107,141,共5页
China Medical Devices
基金
中国博士后科学基金面上资助项目(2019M661805)。
关键词
能谱CT
单能量成像
去金属伪影
心脏起搏器
金属伪影
spectral CT
monoenergetic imaging
metal artifacts reduction
cardiac pacemaker
metal artifacts
